An important note from Steve Gold:

Motorized Wheelchairs and Nursing Homes

Under Medicaid's federal regulations, "each resident must receive and the [nursing] facility must provide the necessary ... services to attain or maintain the HIGHEST practicable physical, mental and psycho-social well being...." Each nursing "facility must care for its residents in a manner ...that PROMOTES ... QUALITY of life," including the "resident has the right to ... interact with members of the community ... outside the facility." [42CFR 483]

You should not accept the nursing home's excuse that the person does not "need" a motorized wheelchair IN the nursing facility or that a motorized chair is too expensive or that the staff does not have time to recharge the batteries.

Nursing homes refuse to provide motorized chairs primarily because they are more expensive than manual chairs, and therefore reduce the nursing home's profit.

The disconnect between the federal regulations and the practice can be overcome!

THINGS YOU CAN DO:

1. Make sure the person wants the motorized wheelchair and says s/he wants the chair to move around the city - outside the nursing facility;
2. Write a letter to the nursing home with the individual stating s/he wants the wheelchair;
3. Have an evaluation of the person conducted outside the nursing home by a separate, non-affiliated facility or doctor!
4. When the nursing home denies the request, ask your state's Medicaid agency for a Fair Hearing. Do it in writing.

When the person in a nursing facility receives a motorized wheelchair and wants to return to the community, many nursing homes contend that the nursing facility owns the chair and the person cannot take it. The result is to perpetuate unnecessary segregation of persons in the institutions.

THINGS YOU CAN DO:

1. Find out if your State Medicaid Plan reimburses nursing facility separately for assistive-technology.
2. Make sure your Olmstead Plan addresses the transition to the community WITH the motorized chair.
3. Check if your State's Medicaid "Home Health Services" or "Rehabilitation Services" provides for durable medical services that are "medically necessary."

Motorized wheelchairs may be critical to the successful transition from nursing homes to the community. Document it when it does not occur! It violates the ADA's requirement that services be provided "in the most integrated setting."

Steve Gold, The Disability Odyssey continues

Back issues of other Information Bulletins are available online at
http://www.stevegoldada.com
with a searchable Archive at this site.